HARCP

HEROIN ADDICTION AND
RELATED CLINICAL PROBLEMS

The official journal of
EUROPAD - European Opiate Addiction Treatment Association
WFTOD - World Federation for the Treatment of Opioid Dependence
Editor: Icro Maremmani, MD - Pisa, Italy, EU
Associate Editors:
Thomas Clausen, MD - Oslo, Norway
Pier Paolo Pani, MD - Cagliari, Italy, EU
Marta Torrens, MD - Barcelona, Spain, EU
Statistical Editor:
Mario Miccoli, PhD - Pisa, Italy, EU

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Heroin Addiction and Related Clinical Problems: 2007, 09, 2 (pages: 39 - 46)

Pharmacokinetic and Pharmacogenetic Factors Influencing Methadone Plasma Levels

Crettol S., Eap C. B.

Summary: Methadone is widely used as a maintenance treatment for opiate addiction. Methadone plasma levels vary widely for a given dose, so contributing to interindividual variability in response to methadone maintenance treatment. Until recently, the relative in vivo involvement of various cytochrome P450 (CYP) isoforms in methadone pharmacokinetics had been unclear. A recent large-scale pharmacogenetic study with patients in methadone maintenance treatment has now demonstrated that CYP3A4 and CYP2B6 are the major cytochrome P450 isoforms with a major involvement in methadone metabolism, while CYP2D6 only contributes to a minor extent. In addition, P-glycoprotein, a transmembrane efflux protein, is also involved in methadone kinetics.

 

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